The patello-femoral pain syndrome: Proposal of clinical and instrumental assessment (original) (raw)

ankle natural mobility while maintaining full conformity, achieved by a backward and forward motion of the meniscal bearing throughout the flexion arc. In this study the expected early functional recovery was evaluated by a clinical scoring system and by gait analysis performed at 6 and 12 months from surgery. Methods: Thirteen patients operated with the BOX Ankle (Finsbury Orthopaedics, UK), with mean age 56.3 years (range 44-71), BMI 25.2 (range 20.4-34.1), 9 males and 4 females, 11 post traumatic ostheo-, 1 psoriasic and 1 rheumatoid arthritis were gait analysed preoperatively and at 6 and 12 month follow-up. The examination consisted in a clinical score (AOFAS) and in gait analysis (Vicon 612 System, Oxford, UK, Kistler forceplates) adopting a recently validated protocol [2]. Results were compared with a 'control group' of 20 subjects, with mean age 27.9 years (range 23-36), BMI 21.9 (range 18.5-25), 11 male and 9 females. Results: AOFAS score rose from 39.9 in pre-op to 81.4 at 12 months, with a considerable reduction of pain (score from 13.1 to 31.5, max 40), and improvement of ankle alignment (from 5.4 to 9.1, max 10) and function (from 21.4 to 40.8, max 50). Spatiotemporal parameters obtained with gait analysis showed a good recovery at 6 months and a successive settlement on the operated site: i.e. mean stride length normalised (81.9, % of height, for control group) was 63.0 pre-op, 70.5 at 6 months and 71.0 at 12 months; speed (127.8 cm/s for control group) rose from 79.2 to 100.8 cm/s at 6 months and 102.7 cm/s at 12 months. Ankle joint rotation range improved in all three anatomical planes at 6 months, somehow maintained at 12 months; in particular in the sagittal, there was an increase of max dorsi-flexion in the stance phase (2.58 pre-op, 5.48 and 6.28 at 6 and 12 months), though a persistent limited plantar-flexion at initial contact and a moderate reduction of plantar-flexion during swing were observed at. Plantar-flexion moment showed a smoother pattern after surgery (Fig. 1). Discussion: The novel ankle prosthesis seems to contribute to an early functional recovery at 6 months maintained at one year. Preliminary assessments at 24 months confirmed the improvements achieved at 12 months. With reduction of pain and recovery of joint control, the gait variables of high clinical interest, such as stance balance and ability in propulsion, improve.